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Edema: M. Rasjad Indra Laboratorium Ilmu Faal Fk. Unibraw

Edema is an increase in the interstitial compartment of extracellular fluid volume. According to Starling's hypothesis, the balance of hydrostatic and oncotic pressures across the capillary endothelium determines fluid movement. Edema can be generalized and pitting or localized and non-pitting. Primary causes include venous or lymphatic obstruction, reduced cardiac output, and hypoalbuminemia. Secondary consequences are renal retention of salt and water. The body has intracellular, interstitial, and extracellular fluid compartments which together make up 60% of total body weight.

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Muhammad Aminuddin
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46 views12 pages

Edema: M. Rasjad Indra Laboratorium Ilmu Faal Fk. Unibraw

Edema is an increase in the interstitial compartment of extracellular fluid volume. According to Starling's hypothesis, the balance of hydrostatic and oncotic pressures across the capillary endothelium determines fluid movement. Edema can be generalized and pitting or localized and non-pitting. Primary causes include venous or lymphatic obstruction, reduced cardiac output, and hypoalbuminemia. Secondary consequences are renal retention of salt and water. The body has intracellular, interstitial, and extracellular fluid compartments which together make up 60% of total body weight.

Uploaded by

Muhammad Aminuddin
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
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Edema

M. Rasjad Indra Laboratorium Ilmu Faal FK. UNIBRAW

Definition
An increase in the interstitial compartement of extracellular fluid volume (Harrisons).

Starling Hypothesis
The balance of hydrostatic and oncotic pressures across the capillary endothelium
Capillary hydrostatic pressure (Pc): 35 mmHg
Interstitial fluid hydrostatic pressure (PIF): 15 mmHg Capillary oncotic pressure (c): 28 mmHg Interstitial fluid oncotic pressure (IF): 3 mmHg Arterial end of capillary: Pc= 35 mmHg; PIF= 0 mmHg c= 28 mmHg; IF= 3 mmHg Net Filtration= 35-0-28+3= 10 Venous end of capillary: Pc= 15 mmHg; PIF= 0 mmHg c= 28 mmHg; IF= 3 mmHg Net Absorption= 15-0-28+3= -10

Types of edema
Generalized edema ~ Edema anasarca
Pitting edema (usually)

Localized edema
Non-pitting edema (usually)

Primary event

Secondary consequences

Venous / lymphatic obstruction; reduction of cardiac output; hypo-albuminemia Renal retention of salt & water

Body Fluid Compartment

Body Fluid Volume


Body fluid 60% (45-75) water Intracellular 40 % (42 liter in 70 kg young adult) Interstitial 15 % (10.5 liter in 70 kg young adult) Extracellular 20 % (14 liter in 70 kg young adult) Plasma 5% (3.5 liter in 70 kg young adult) Transcellular 1-3 % (Cerebrospinal) (Aqueous humor)

Daily Intake and Output of Water (in ml/day)


Normal Intake Fluid ingested From metabolism Total intake Output Insensible-Skin Insensible-Lungs Sweat Feces Urine Total output Prolonged Heavy Exercise ? 200 ? 350 650 5000 100 500 6600

2100 200 2300 350 350 100 100 1400 2300

Causes of Extracellular Edema

1. Increased capillary pressure


Excessive kidney retention Acute glomerulonephritis Acute tubular necrosis
Sodium & water retention

High venous pressure Local obstruction in venous drainage Congestive heart failure. Decreased arteriole resistance Vasodilatation

2. Decreased plasma proteins:

Nephrotic syndrome Loss of protein from denuded skin Combustio Failure of produce protein Cirrhosis hepatis

Loss of protein in urine

3. Increased capillary permeability


Immune reaction Hypersensitivity reaction Toxin Injury to capillary endothelium Bacteria infection Injury to capillary endothelium Inflammatory process (nonpitting edema) Vitamin deficiency (exp. Vit C)

4. Blockage of lymph return


Cancer Paracyte infection (Filaria) Surgery Congenital absence or abnormal of lymphatic vessels

Sequence of events leading to the retention of Na & H2O and the development of edema

Heart failure

Plasma oncotic pressure Blood vol

Internal fluid trapping

Central Venous Pressure

Cardiac output Effective arterial blood vol.

Capillary pressure

Renal vasoconstriction
GFR

Renin
Aldosteron

Natriuretic

ADH

Transudation Interstitial vol.

H2O retention

Renal retention of Na & H2O Plasma vol. Edema Interstitial vol. Transudation

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